Adding or improving fertility benefits at your organization can make a profound difference to your employees struggling to build their families. In 2022, 61% of employers1 with 500 or more employees provided some fertility insurance coverage. Additionally, 58% of benefits specialists believe not offering fertility benefits is discriminatory.
Small to medium-sized businesses can have a hard enough time providing health insurance, let alone comprehensive fertility benefits. However, considering that fertility methods cost tens of thousands of dollars, it’s easy to see the appeal of a company of any size that’s willing to help foot the bill.
In this blog, we’ll go over why you should offer fertility and pregnancy-related benefits, common fertility benefits that employees want, and how you can cover the cost with an integrated health reimbursement arrangement or a stipend.
Learn more about health reimbursement arrangements (HRAs) in our complete guide
Why you should offer fertility benefits
Offering comprehensive fertility benefits is critical for organizations striving to be more inclusive. After all, fertility is not just a women’s issue.
Family-planning benefits should meet the needs of employees of any orientation and gender identity to be truly inclusive, including same-sex couples, LGBTQ+ employees, and male staff members. This benefit should also extend to single parents, as an infertility diagnosis isn’t bound by marital status.
Additionally, fertility benefits are becoming a top consideration in today’s job market. One study2 found that 88% of employees said they would switch jobs to get fertility coverage. 61% of employees with fertility benefits also reported greater company loyalty and improved workplace culture.
With these stats, it’s easy to see that fertility coverage can help employers recruit and retain top talent.
Here are four advantages that come from offering fertility insurance:
- Long-term healthcare savings by supporting early fertility care
- Improved employee morale and company loyalty
- Appeal to a more diverse pool of job candidates that value inclusive benefits
- Enhanced reputation as a family-friendly organization
Offering family planning benefits can also be a cost-effective way to increase productivity. An employer benefit that provides clinical oversight throughout an employee’s fertility journey increases the likelihood of a successful pregnancy while decreasing pharmacy costs, invasive treatments, premature infant care, and other health-related costs, leading to happier and more present employees.
Common fertility benefits that employees want covered
Employees who experience an infertility diagnosis may look to their benefits package to see what treatment options are covered. That’s why some employers have started offering comprehensive coverage for fertility services as part of their health insurance plan.
According to the World Health Organization3, infertility impacts about 17.5% of adults worldwide, or 1 in 6 people. Even an otherwise healthy individual can require infertility care for a variety of reasons.
Ensuring you’re offering the right fertility benefits that employees commonly ask for is an excellent place to start when designing your health benefit.
The six most commonly covered fertility treatments for employees are:
- Fertility preservation procedures, including donor egg procurement, embryo freezing, and donor sperm collection.
- Intrauterine insemination.
- Mental health counseling and resources for those struggling with fertility issues.
- Non-in vitro fertilization (IVF) treatment.
- Diagnostic testing, including genetic testing, imaging, and other examinations.
- Medical treatment services, including infertility drugs, artificial insemination, and surgery.
However, family benefits don’t have to be exclusive to medical conditions. Other popular family-friendly benefits include flexible work schedules, paid maternity and paternity leave, paid time off, adoption assistance, child care, and more.
Is IVF covered by insurance?
Most health insurance plans consider maternity and infant care essential health benefits, but infertility care often isn’t covered. About 1 in 4 married women4 in the U.S. aged 15 to 49 have trouble getting pregnant, making IVF a popular option. But even though demand grows, coverage for fertility care continues to be limited.
According to Forbes5, the average price of an IVF cycle can cost between $12,000 to $14,000. With fertility medication and other prescription drugs, the cost can rise to $30,000.
One insurance provider may cover IVF but not the injections that a covered person may also require. Other plans may only cover a limited number of retrievals per lifetime. And some health benefit plans don’t cover IVF—they may just cover diagnostic services.
If you provide traditional group health insurance, your employees aren’t necessarily guaranteed coverage. So if IVF is a priority for many of your employees, you’ll want to provide them with a health insurance policy that offers as much coverage for these medical conditions as possible.
Remember, just because a medical professional says someone is a candidate for IVF doesn’t mean they’ll be automatically eligible for care—that’ll be up to the fertility benefits provider, insurance plan, and network providers.
How to confirm if your insurance covers IVF
If you already have health insurance coverage at your organization, you can check your summary of benefits, or explanation of benefits page, to find out if your insurance policy covers IVF. If you have employees asking about their infertility coverage, they can request the most recent copy from your HR department, benefits specialist, or health insurance company.
If you have little to no access to infertility services, there are ways your employees can advocate treatment for a successful pregnancy:
- They can speak to their fertility specialist about potential IVF clinical trials.
- They should keep copies of receipts showing they’ve spent money on fertility treatment, diagnostic testing, or other related care. Their financial advisor can determine if they can be classified as “medical” during tax season.
- If you offer a flexible spending account (FSA), health savings account (HSA), or health reimbursement arrangement (HRA), employees can use those funds towards IVF for that year.
- They can research fertility financing options.
While it’s your employees’ responsibility to understand their health benefits, you should be able to point them in the right direction for clarification. Additionally, if a fertility doctor is already treating them, they may have access to an onsite financial advisor who can also help.
How employers can cover the cost of fertility benefits
Despite a need for infertility services, fertility coverage is inaccessible to many because of the cost. Most fertility assistance services aren’t fully covered by their insurance company.
Some employers get supplemental insurance coverage to fill in gaps in their traditional group insurance health plans to remedy this. But even so, a covered individual will most likely still pay high out-of-pocket costs for fertility treatment depending on the fertilization services needed to have a viable pregnancy.
Luckily, the two options we’ll explain below allow you to offer your employees personalized fertility coverage without exceeding your budget.
Your first option is an integrated HRA. An integrated HRA, or group coverage HRA (GCHRA), is a tax-free reimbursement arrangement between an employer and a covered individual to help them pay for out-of-pocket costs not fully paid for in their group health insurance plan.
With a GCHRA, you set a monthly allowance for your employees to use on healthcare. The allowance you can set is unlimited, so if you’re aiming for top fertility care and benefits, the sky's the limit on how much you can give your employees.
Eligible expenses related to infertility treatment that are reimbursable with a GCHRA include the following:
- Fertility and ovulation monitors
- Visits to fertility clinics
- Artificial insemination
- Infertility diagnosis and treatment
- Fertility preservation coverage
- Pregnancy tests, medical treatment, and much more
Allowances can’t be exceeded, and any unused allowance stays with you when an employee leaves the organization, making a GCHRA an affordable solution to offering infertility benefits while increasing your employees' chances of having a successful pregnancy.
Another family-building benefit that can help your employees cover the price of fertility treatments is a health stipend. A health stipend is a fixed sum of money offered to employees to purchase necessary medical services.
Just like an integrated HRA, there is no dollar limit regarding how much you can offer your employees with a stipend. But unlike an HRA, stipend money is typically counted as taxable income, increasing your and your employees’ tax liability.
Health stipends can be easier to administer than HRAs and other health benefit plans. Because you can set up a stipend for anything, they are very flexible to whatever medical services your employees need, whether it’s family planning, IVF, adoption reimbursement, egg retrieval, surrogacy services, or child care.
What’s more, when offering health stipends as a supplemental benefit to your existing group plan, they aren’t subject to the Affordable Care Act’s regulations.
However, you can’t require your employees to prove that they’re using their health stipend toward the expenses you intended them to, meaning there is no accountability for whether their stipend allowances toward fertility or family planning services.
Access to fertility care, IVF, and pregnancy-related benefits are no longer considered a nice-to-have insurance option—they’re a must-have benefit for you to support your employees and be recognized as a family-friendly organization. Even in this tight labor market, you can offer top-notch fertility benefits to attract and retain top talent without breaking the bank.
An integrated HRA or a health stipend can provide an all-in-one solution to support a successful pregnancy and fertility benefits at an affordable price. If you think one of these personalized benefit solutions suits your company, contact our team, and we’ll get you on your way!
This article was originally published on March 2, 2022. It was last updated on May 31, 2023.
- 1. https://www.get-carrot.com/blog/why-fertility-benefits
- 2. https://www.get-carrot.com/fertility-at-work
- 3. https://www.who.int/news/item/04-04-2023-1-in-6-people-globally-affected-by-infertility
- 4. https://www.cdc.gov/reproductivehealth/infertility/
- 5. https://www.forbes.com/health/family/how-much-does-ivf-cost/